Genipin in an Ex Vivo Corneal Model of Bacterial and Fungal Keratitis.

Purpose: To determine whether genipin (a natural crosslinker) could reduce the colonization and proliferation of bacteria and fungi in an ex vivo model of corneal infection. Methods: This study, using an ex vivo model of bacterial and fungal keratitis, investigated the antimicrobial efficacy of genipin crosslinking. Excised corneoscleral buttons were wounded by scalpel incision and subsequently infected with Staphylococcus aureus, Pseudomonas aeruginosa, or Candida albicans. After inoculation, corneas were treated with genipin for 24 hours at 37°C. Histologic examinations were carried out, and the number of viable colony-forming units (CFU)/cornea was determined. Results: Genipin exerts bactericidal action against S. aureus and P. aeruginosa, as well as fungicidal action against C. albicans and significantly reduced the CFU compared to contralateral eyes that received saline treatment (P < 0.05). Conclusions: These data identify genipin as a novel ocular antimicrobial agent that has the potential to be incorporated into the therapeutic armamentarium against microbial keratitis. Translational Relevance: This study provided evidence for the antimicrobial and antifungal properties of genipin as an alternative crosslinker that could be used in the management of infectious keratitis.

Acrylamide in non-centrifugal sugar from Latin American markets: in-house validation of an LC-MS/MS method, dietary exposure assessment and risk characterisation in Brazil and Colombia.

A liquid chromatography tandem mass spectrometry method (LC-MS/MS) preceded by a rapid and simple QuEChERS-based sample preparation was developed and validated for the determination of acrylamide in non-centrifugal sugar (NCS), a solid product obtained from sugarcane juice without centrifugation, up to a concentration greater than 90 ºBrix. Adequate linearity in calibration curves, analytical selectivity and sensitivity were achieved. A limit of detection (LOD) and a limit of quantitation (LOQ) of 10 and 20 µg kg-1, respectively, were obtained. Recoveries (84.3-107.5%) and coefficients of variation (CV<15%) for repeatability and reproducibility conditions were appropriate in intraday and interday laboratory conditions. The concentration of acrylamide was determined in 76 commercial samples of NCS from different Latin American countries and ranged from <20 to 1414 µg kg-1. The highest mean acrylamide amounts were found in samples from Peru, Ecuador and Colombia (636, 446 and 401 µg kg-1, respectively). Considering the form of the product, the highest average levels were found in granulated NCS (517 µg kg-1) when compared to block (294 µg kg-1). Within the Colombian samples, organic NCS, made with natural flocculant, presented a higher acrylamide mean concentration (721 µg kg-1) than conventional samples (363 µg kg-1). Although the Margin of Exposure (MOE) values for neurotoxicity suggested that the estimated intakes in Brazil and Colombia are not a concern, MOEs obtained for neoplastic effects raised attention.

Síndrome autoinmune tirogástrico (SAT): serie de casos / Thyrogastric syndrome: Case Series

Resumen Un porcentaje importante de pacientes con gastritis crónica atrófica corporal autoinmune, o gastritis tipo A, desarrollan enfermedad autoinmune tiroidea (enfermedad de Graves o de Hashimoto) y viceversa, situación conocida como síndrome autoinmune tirogástrico (SAT), pero no se conoce su prevalencia, por lo que puede pasarse sin el diagnóstico completo. El desarrollo de la gastritis atrófica limita la absorción de la vitamina B12, lo que lleva a alteraciones hematológicas, neurológicas y metabólicas, por tanto, es importante realizar las pruebas necesarias para su diagnóstico y seguir de cerca la evolución de los pacientes. La detección serológica de los autoanticuerpos contra la glándula tiroides y el cuerpo gástrico muestran la etiología autoinmune y un estado inflamatorio con daño tisular. Todo paciente con enfermedad autoinmune debe ser valorado para descartar la presencia de otras patologías de etiología inmunológica.

Abstract A significant percentage of patients with chronic autoimmune atrophic body gastritis (type A gastritis) develop thyroid autoimmune disease (Graves' disease or Hashimoto's disease) and vice versa. This situation is known as thyrogastric syndrome. Its prevalence is unknown, due to incomplete diagnoses. Since the development of atrophic gastritis limits the absorption of vitamin B12 leading to hematological, neurological and metabolic alterations, it is important to perform necessary diagnostic tests and to closely monitor the evolution of patients. Serological detection of autoantibodies against the thyroid gland and the gastric body show the autoimmune etiology and an inflammatory state with tissue damage. Every patient with autoimmune disease should be evaluated to rule out the presence of other pathologies of immunological etiology.

Randomized Clinical Trial for the Evaluation of Immune Modulation by Yogurt Enriched with ß-Glucans from Lingzhi or Reishi Medicinal Mushroom, Ganoderma lucidum (Agaricomycetes), in Children from Medellin, Colombia.

Pattern recognition receptor (PRR) agonists are promising for use in modulating immune responses in clinical settings characterized by immune immaturity or deficiency. ß-Glucans derived from Ganoderma lucidum have demonstrated immune-modulatory activity both in vitro and in vivo. To evaluate the immunomodulatory activity of orally administered ß-glucans, a randomized, double-blinded, placebo-controlled clinical study was performed in asymptomatic children, aged 3 to 5 years old, from Medellin, Colombia. Primary outcomes were the circulating CD8+ T lymphocyte and natural killer cell counts; secondary outcomes were circulating lymphocyte counts (total, CD3+, and CD4+ T cells), serum concentrations of total immunoglobulin A and cytokines, and various hematological parameters. The treatments were administered daily for 12 weeks, and physical and laboratory evaluations were performed at days 0 and 84. Children in the group receiving a yogurt with ß-glucans presented a significantly higher absolute count of peripheral blood total lymphocytes (CD3+, CD4+, and CD8+ T cells) than that in the group receiving placebo. The interventions were safe and well tolerated; no abnormal increases in serum creatinine or hepatic aminotransferases occurred, and adherence was higher than 90% in the intervention groups. This study demonstrates that ß-glucans from G. lucidum increase the frequency of immune system cells in the peripheral blood; these cells are critical in the defense against infectious threats in asymptomatic children 3 to 5 years old. These findings warrant longer controlled clinical trials that aim to evaluate the efficacy of ß-glucans in preventing infections in healthy children and to define their potential to enhance lymphoid cell number and functions in various lymphoid immune deficiencies.

Evaluación de la colonización bacteriana de la interfase implante-pilar en implantes de conexión interna: estudio piloto / Evaluation of bacterial colonization of the implant-abutment interface in implants with internal connection: pilot study

Introducción: la interfase implante-pilar da lugar a la formación de un espacio, cuyo tamaño varía de acuerdo a variables como las tolerancias de maquinado, los micro- movimientos, el tipo de fabricación de los aditamentos protésicos y el material de los mismos. Este espacio, en cercanía a los tejidos peri-implantares, es una oportunidad para la movilización de microorganismos de forma bidireccional, desencadenando eventualmente respuesta tisular. Objetivo: comparar la filtración de Echerichia coli (E. coli) en la interfase de implantes de conexión interna con pilares prefabricados y personalizados. Materiales y métodos: nueve implantes (Osseotite® Tapered Certain®, 3i Biomet) fueron divididos en tres grupos basados en el tipo de pilar utilizado. Grupo 1 pilares prefabricados Provide®, grupo 2 pilares personalizados Encode® Titanio, grupo 3 pilares personalizados Encode® Zirconia. Los pilares fueron conectados a los implantes y fueron ciclados según la norma ISO 14801:2007 (250.000 ciclos) en un dispositivo de carga dinámica. Fueron sumergidos en caldo infusión cerebro corazón (BHI) inoculado con E. coli. Se tomaron muestras y se midió la turbidez del medio. Se realizó test ANOVA para comparar el tamaño de la interfase implante-pilar. Resultados: se encontró que todas las muestras filtraron en diferentes proporciones. Conclusiones: todas las muestras mostraron filtración de E. coli.

Background: the implant-abutment interface leads to the formation of a space whose size varies according to different variables such as machining tolerances, micro-movements, the type of fabrication of prosthetic devices and the fabrication material. This space in close proximity to the peri-implant tissues is an opportunity for the colonization of microorganism bidirectionally, eventually triggering tissue response. Objective: to compare the filtration of Echerichia coli (E. coli) in the interface of implants of internal connection with prefabricated and customized abutments. Materials ands methods: nine implants (Osseotite® Tapered Certain®, 3i Biomet) were divided into three groups based on the type of abutment used. Group 1 prefabricated abutment Provide®, Group 2 customized abutment Encode® Titanium, Group 3 customized abutment Encode® Zirconia. The implants were connected to the abutments and cycled according to ISO 14801:2007 norm (250,000 cycles) in a dynamic loading device. They were immersed in brain heart infusion (BHI) medium inoculated with E. coli. Samples were taken and the turbidity of the medium was measured. An ANOVA test was performed to compare the size of the implant-abutment interface. Results: All samples were found to be colonized in different proportions. Conclusions: All samples showed E. coli colonization.

Tiempo requerido de enfermería para un cuidado con calidad / Nursing time required for quality care

Objetivo: Identificar el tiempo requerido de enfermería para el cuidado, la educación, la investigación y la gestión del cuidado y del servicio, a fin de determinar el talento humano necesario para la prestación del cuidado con calidad en un hospital de primer nivel de atención. Método: Estudio descriptivo-transversal realizado con estudiantes de enfermería del último semestre de pregrado. Se aplica el proceso de atención de enfermería (PAE), siguiendo los criterios de la NANDA y la valoración con cada sujeto de cuidado. Desde los diagnósticos y las intervenciones de enfermería se determina el tiempo para el cuidado, se utiliza la técnica de análisis por consenso desde la evidencia para calcular el tiempo para la investigación, la educación, la gestión del cuidado y del servicio. Resultados: Se identifican 182 diagnósticos de enfermería con sus intervenciones y el respectivo tiempo para el cuidado, por paciente y por profesional y auxiliar de enfermería en el servicio de hospitalización. También se evidencia el tiempo para las funciones que el personal de enfermería debe realizar que no son cuidado directo, pero que facilitan el logro de objetivos y ayudan al ideal de un cuidado con calidad y centrado en el sujeto del cuidado. Se elaboran 68 guías de enfermería para la unificación de criterios. Conclusiones: Calcular el talento humano de enfermería debe partir de las necesidades de los sujetos de cuidado en su contexto y de la estimación del tiempo para la gestión del cuidado y del servicio, así como para la educación e investigación.

Objective: To identify the nursing care time, education, research and care management and service, to determine the human talent needed for the provision of quality care at a hospital in primary care. Method: descriptive cross-sectional study with last semester nursing students. The nursing care plan (NCP) is applied, following the criteria from the NANDA and an assessment is carried with each care subject. The time for care is determined from the diagnoses and nursing interventions; the consensus methodology for analyzing evidence is used to calculate the time for research, education, care management and service. Results: 182 nursing diagnoses were identified with its interventions and their respective time care per patient, professional, and auxiliary nursing inpatient service. There is also evidence of time for functions that nurses should carry out which are not direct care, but which facilitate the achievement of goals and help the ideal of quality and subject-centered care .68 nursing guidelines for the unification of criteria were developed. Conclusions: Calculating nursing human talent must emerge from the needs of the care subjects in their context, from time estimation for care management and service, as well as for education and research.

Evaluation of the Care Safety of Patients with Surgical Interventions from a High-Complexity Institution in Medellín, Colombia / Segurança da atenção dos pacientes com intervenções cirúrgicas de uma instituição de alto nível de complexidade em Medellín, Colômbia / Seguridad de la atención de los pacientes con intervenciones quirúrgicas de una institución de alto nivel de complejidad en Medellín, Colombia

Abstract Objective. This work sought to evaluate care safety of patients with surgical interventions in the area of general surgery in terms of administrative problems in caring, incidents, and adverse events. Methods. This was an observational-type prospective descriptive study that followed up patients intervened surgically by the general surgery group of a tier IV hospital unit in the city of Medellín. Results. The study evaluated 182 patients who received complete follow up during the care process in the institution; of these, 59 (32.4%) received unsafe care (10 incidents, 9 problems with quality, and 40 adverse events); the remaining 123 (67.6%) had safe care of which, 28 developed complications in spite of not having had flaws in the care process. Regarding the health professionals responsible for patient care, we found that 57.4% of the adverse events was the responsibility of the treating physician and the remaining 42.6% was the responsibility of the nursing staff. Conclusion. The prevalence of adverse surgical events in this study was above that found in literature. Management of nursing care focused on improving the healthcare system in the area of surgery could reduce substantially not only the occurrence of flaw in caring, but also the economic burden upon the healthcare system.

Resumo Objetivo. Avaliar a segurança na atenção dos pacientes com intervenções cirúrgicas na área de cirurgia geral em termos de problemas administrativos para a atenção, incidentes e eventos adversos. Métodos. Estudo descritivo prospectivo de tipo observacional que realizou seguimento a pacientes intervidos cirurgicamente pelo grupo de cirurgia geral de uma unidade hospitalar de quarto nível de complexidade da cidade de Medellín (Colômbia). Resultados. Se avaliaram 182 pacientes a quem se lhes realizou o seguimento completo durante processo de atenção na instituição, de estes 59 (32.4%) tiveram atenção insegura (10 incidentes, 9 problemas com a qualidade e 40 eventos adversos); os 123 restantes (67.6%), atenção segura, dos quais, 28 desenvolveram complicações a pesar de não haver tido falha no processo de atenção. Com relação ao profissional da saúde responsável da atenção dos pacientes, encontramos que 57.4% dos eventos adversos foi responsabilidade do médico tratante e 42.6% restante foi responsabilidade do pessoal de enfermagem. Conclusão. A prevalência de evento adverso cirúrgico neste estudo foi superior à encontrada na literatura. A gestão do cuidado de enfermagem enfocada à melhora do sistema de atenção na área de cirurgia poderia reduzir substancialmente não só a ocorrência da falha da atenção senão também a carga econômica que isto implica ao sistema de atenção em saúde.

Resumen Objetivo. Evaluar la seguridad en la atención de los pacientes con intervenciones quirúrgicas en el área de cirugía general en términos de problemas administrativos para la atención, incidentes y eventos adversos. Métodos. Estudio descriptivo prospectivo de tipo observacional que realizó seguimiento a pacientes intervenidos quirúrgicamente por el grupo de cirugía general de una unidad hospitalaria de cuarto nivel de complejidad de la ciudad de Medellín (Colombia). Resultados. Se evaluaron 182 pacientes a quienes se les realizó el seguimiento completo durante proceso de atención en la institución, de ellos 59 (32.4%) tuvieron atención insegura (10 incidentes, 9 problemas con la calidad y 40 eventos adversos); los 123 restantes (67.6%), atención segura, de los cuales, 28 desarrollaron complicaciones a pesar de no haber tenido falla en el proceso de atención. Con relación al profesional de la salud responsable de la atención de los pacientes, encontramos que el 57.4% de los eventos adversos fue responsabilidad del médico tratante y el 42.6% restante fue responsabilidad del personal de enfermería. Conclusión. La prevalencia de evento adverso quirúrgico en este estudio fue superior a la encontrada en la literatura. La gestión del cuidado de enfermería enfocada a la mejora del sistema de atención en el área de cirugía podría reducir sustancialmente no solo la ocurrencia de la falla de la atención sino también la carga económica que ello conlleva al sistema de atención en salud.

Evaluation of the Care Safety of Patients with Surgical Interventions from a High-Complexity Institution in Medellín, Colombia.

OBJECTIVES: This work sought to evaluate care safety of patients with surgical interventions in the area of general surgery in terms of administrative problems in caring, incidents, and adverse events. METHODS: This was an observational-type prospective descriptive study that followed up patients intervened surgically by the general surgery group of a tier IV hospital unit in the city of Medellín. RESULTS: The study evaluated 182 patients who received complete follow up during the care process in the institution; of these, 59 (32.4%) received unsafe care (10 incidents, 9 problems with quality, and 40 adverse events); the remaining 123 (67.6%) had safe care of which, 28 developed complications in spite of not having had flaws in the care process. Regarding the health professionals responsible for patient care, we found that 57.4% of the adverse events was the responsibility of the treating physician and the remaining 42.6% was the responsibility of the nursing staff. CONCLUSIONS: The prevalence of adverse surgical events in this study was above that found in literature. Management of nursing care focused on improving the healthcare system in the area of surgery could reduce substantially not only the occurrence of flaw in caring, but also the economic burden upon the healthcare system.

Determinación de los cambios en altura y densidad ósea después de un proceso de preservación con un sustituto óseo sintético / Determination of changes in height and bone density after process preservation with synthetic bone substitute

Objetivo: Determinar los niveles de altura y densidad osea alcanzada en alvéolos pos - texodoncia, 15 dias y tres meses despues de ser injertados con un sustituto óseo experimental. Materiales y Métodos: Se distribuyeron aleatoriamente 37 alvéolos postexodoncia en dos grupos, uno experimental (n=21) y otro control (n=16). En el grupo expe- rimental se utilizó un material compuesto por ß-Fosfato tricalcico y quitosano, en el grupo control se empleó un producto co- mercial compuesto por una mezcla bifásica de hidroxiapatita (HA) y fosfato tricalcico (TCP). Se realizaron tomografías a los 15 días y 3 meses postquirúrgicos determi - nando niveles óseos (altura y anchura en la zona injertada); también se determinó la densidad ósea utilizando unidades Houns- field. La información obtenida se procesó con la aplicación STATA versión 13. Se calcularon frecuencias para el sexo, tipo de alvéolo y tipo de injerto utilizado, y para las variables numéricas de edad, densidad ósea, altura ósea, grosor crestal, se establecieron promedios y desviación estándar. El nivel de confianza se estableció en 95% y el nivel de significancia en 5%. Resultados: Al comparar la densidad y altura ósea en los dos grupos no se encon- traron diferencias estadísticamente signifi - cativas, pero si al comparar el ancho en la zona de la cresta ( p <0.05). Conclusiones: El biocompuesto cerámico con quitosano mostró ser útil en preservar niveles óseos en los alvéolos postexodoncia y presentó diferencias estadísticamente significas en el ancho del reborde

Aim: Determine bone density and height reached fifteen (15) days and three (3) months after being grafted an sockets with a synthetic bone substitute and compared with experimental ceramic biocomposite. Materials and Methods: Thirty-seven sockets (37) selected randomly were gra - fted in clinics of the University of Valle, sixteen sockets (16) for control group and twenty (21) for the experimental group. CT scans were performed at 15 days and 3 months post-surgery determining bone levels: vertical height and width in the gra - fted area; bone density is also determined by analyzing Hounsfield units. The infor - mation obtained was processed with the STATA version 13 application frequencies for gender, type of socket and type of graft used, and for numeric variables of age, bone density, bone height, thickness crestal, averages were established and deviation were calculated standard. The confidence level was set at 95% and the significance level of 5%. Results: Bone density and height, no statis - tically significant differences between the intervention group (group 1) and control (group 2). For peak thickness statistically significant differences ( p <0.05). The va - riation or change between start and end of follow within each group found that there is no statistically significant difference. Conclusions: The ceramic biocomposite with chitosan and graft tricalcium phospha - te and hydroxyapatite no statistically significant differences in density and height in the scans at 15 and 90 days. The bone width showed statistically significant differences

Análisis macroscópico de los tejidos dentales y periodontales de cerdo (Sus domesticus) sometidos a altas temperaturas / Macroscopic analysis of dental and periodontal tissues of pig (Sus domesticus) exposed to high temperatures

Objetivo: Describir los cambios físicos macros-estructurales de los tejidos dentales (esmalte, dentina y cemento) y periodonta - les (mucosa oral, hueso compacto alveolar y hueso esponjoso alveolar) de cerdo doméstico sometidos a altas temperaturas. Materiales y métodos: Se realizó un estudio observacional descriptivo de naturaleza pseudo-experimental in Vitro para observar los cambios físicos macro-estructurales de los tejidos dentales y periodontales en 25 dientes de cerdo doméstico sometidos a altas temperaturas (200ºC, 400ºC, 600ºC, 800ºC, 1000ºC). Resultados: Los tejidos dentales y pe - riodontales estudiados presentan gran resistencia al someterse a altas tempe - raturas sin variar considerablemente su macro-estructura. A 200°C hay cambios de color y aparecen fisuras en esmalte. A 400°C aumentan las fisuras y hay sepa - ración entre los tejidos duros, iniciando la carbonización. A 600°C las fracturas en los tejidos dentales y hueso son más evidentes. A 800°C inicia incineración de los tejidos. A 1000°C no hay evidencia de tejidos blandos, hay estallido de la corona y fragmentación del tejido óseo. Conclusiones: El análisis macroscópico de los dientes de cerdo doméstico articulados en sus respectivas unidades alveolo-den- tarias se constituye en un modelo experi - mental que simula de manera fehaciente el comportamiento de los tejidos dentales y periodontales al ser sometidos a altas temperaturas, sin embargo, se recomienda realizar un estudio en dientes humanos ar - ticulados en su respectiva unidad alveolar, para determinar si dichos cambios se repi- ten y son extrapolables, para ser empleados en procesos de identificación odontológica y documentación de la necropsia médico- legal en el caso de cadáveres o restos huma - nos quemados, carbonizados o incinerados...(Au)

Objective: To describe the physical chan- gesof macro-structural dental tissues (ena- mel, dentin and cement) and periodontal (oral mucous membrane, alveolar compact bone and cancellous alveolar bone) of domestic pig (Sus domesticus) expose to high temperatures. Materials and methods: This descriptive study observed the physical changes in ma - cro-structural dental tissues and periodontal in 25 teeth of domestic pigs subjected to high temperatures (200°C, 400°C, 600°C, 800°C and 1000°C). Results: Dental and periodontal tissues stu - died show great resistance when subjected to high temperatures without changing sig - nificantly their macro-structure. At 200°C no color changes and cracks appear in the enamel. At 400°C there was an increase of the fissure and no separation between the hard tissues, initiating carbonization. At 600°C fractures in the dental tissues and bone are most apparent. At 800°C burning of the tissues initiated. At 1000°C there was no evidence of soft tissue. Conclusions: Macroscopic analysis of the teeth articulated in their alveolar-dental units constitutes a experimental model that ssimulates the changes of dental and perio - dontal tissues expose to high temperature. It is recommended to conduct astudy on human teeth in their respective unit arti- culated alveolar to determine whether the macro-structural physical changes descri- bed are repeated and can be extrapolated, and which can eventually be used during the process of dental identification and documentation of the medical legal autopsy used in the case of bodies or human remains burned, charred and burned...(Au)

Riesgo cardiovascular, calidad de vida y años de vida ajustados por calidad: un estudio de caso / Cardiovascular risk, quality of life and quality-adjusted years of life: a case report / Risco cardiovascular, qualidade de vida e anos de vida ajustados por qualidade: um estudo de caso

Objetivo: determinar la razón costo-utilidad de un programa de promoción y prevención de enfermedades cardiovasculares (ECV) en una institución que presta servicios de salud en la ciudad de Medellín (Colombia). Metodología: se comparó el programa preventivo con el esquema de control convencional bajo el diseño de un estudio cuasi-experimental de evaluación antes y después con grupo control no equivalente. Entre los grupos de estudio se evaluaron diferencias al final del primero y segundo año de los siguientes resultados: puntaje de Framingham, costo directo para el programa, calidad de vida, índice de salud y años de vida ajustados por calidad. Resultados: entre los grupos evaluados se encontró diferencia estadísticamente significante entre los momentos inicial y final para las variables: puntaje de Framingham, índice de salud y años de vida ajustados por calidad. Conclusión: la participación de los pacientes en programa de promoción y prevención de ECV está relacionado con reducción en el riesgo y mejoría en la calidad de vida.

Objective: to determine the ratio cost-utility of cardiovascular diseases (CVD) promotion and prevention programs in a health care providing institution in the city of Medellin (Colombia). Methodology: the preventive program was compared before and after with the conventional control scheme under the design of a quasi experimental study evaluation with a non equivalent control group. Between the studied groups differences of the following results were evaluated at the end of the first and second year: Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Results: in the evaluated groups a statistically meaningful difference was found between the initial and final moments for the variables: Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Conclusion: the participation of patients in CVD prevention and promotion programs is related with risk reduction and a better quality of life.

Objetivo: determinar a razão custo-utilidade de um programa de promoção e prevenção de doenças cardiovasculares(ECV) numa instituição que presta serviços de saúde na cidade de Medellín (Colômbia). Metodologia: comparou-se o programa preventivo com o esquema de controle convencional sob o desenhode um estudo quase-experimental de avaliação antes e depois com grupo controle não equivalente. Entre os grupos de estudo se avaliaram diferenças ao final do primeiro e segundo ano dos seguintes resultados: pontuação de Framingham, custo direto para o programa, qualidade de vida, índice de saúde e anos devida ajustados por qualidade. Resultados: entre os grupos avaliados se encontrou diferença estatisticamente significante entre os momentos inicial e final para as variáveis: pontuação de Framingham, índice de saúde e anos de vida ajustados por qualidade. Conclusão: a participação dos pacientes em programa de promoção e prevenção de ECV está relacionada com redução no risco e melhoria na qualidade de vida.

Frictional evaluations of dental typodont models using four self-ligating designs and a conventional design.

Abstract: After a previous study using typodonts and three standardized archwire (AW) sizes, the frictional evaluations of four self-ligating brackets were directed toward the optimal AW-bracket system. Four participating manufacturers suggested three AWs, which were a representation of the three stages of orthodontic treatment, to be coupled with their respective self-ligating design. Four replicated typodont models were mounted with a self-ligating design, and a fifth model was mounted with a conventional design that served as a control. The first experiment evaluated the manufacturer-suggested AWs against the respective self-ligating design. Because no third-stage AWs could engage their respective designs, a second experiment was implemented to gain more detailed analyses of the designs. This experiment included any successful manufacturer-suggested AWs from the first experiment against the four self-ligating designs and the control design. All self-ligating designs performed with the efficiency and reproducibility associated with expectations. Specifically, self-ligation outperformed the conventional brackets when coupled with up to 0.020- x 0.020-inch wires. The clearance of the various AW sizes and alloys changed with malocclusion. Furthermore, the parameter that best correlated with drawing forces was the bending stiffness of the AW, which was directly associated with the nominal dimension of each wire. The best AW-bracket system can be selected, when taking into account the stiffness (elastic modulus and size of the AW) along with the amount of malocclusion present, once the treatment plan is determined.

Evaluation of the frictional resistance of conventional and self-ligating bracket designs using standardized archwires and dental typodonts.

The frictional behavior of four conventional and four self-ligating brackets were simulated using a mechanical testing machine. Analyses of the two-bracket types were completed by drawing samples of three standardized archwires through quadrants of typodont models in the dry/wet states. Pretreatment typodonts of an oral cavity featured progressively malocclused quadrants. As nominal dimensions of the archwires were increased, the drawing forces of all brackets increased at different rates. When coupled with a small wire, the self-ligating brackets performed better than the conventional brackets. For the 0.014-inch wires in the upper right quadrant, the maximum drawing forces averaged 125 and 810 cN for self-ligating and conventional brackets, respectively. When coupled with larger wires, various designs interchangeably displayed superior performance. For the 0.019- x 0.025-inch wires in the upper left quadrant, the maximum drawing forces averaged 1635 and 2080 cN for self-ligating and conventional brackets, respectively. As the malocclusion increased, the drawing forces increased. For example, in the least malocclused quadrant and with the smallest wire, maximum drawing forces for self-ligating and conventional brackets averaged 80 and 810 cN, respectively, whereas in the most malocclused quadrant tested with the same wire size, maximum drawing forces for self-ligating and conventional brackets averaged 870 and 1345 cN, respectively. For maximum values between the dry and wet states, significant differences between ambient states existed only for the In-Ovation brackets in the lower left quadrant. These test outcomes illustrated how bracket design, wire size, malocclusion, and ambient state influenced drawing forces.

Anemia perniciosa: Presentacion de casos y revision de temas / Pernicious anemia

La anemia perniciosa es considerada una enfermedad autoinmune, en la cual coexisten la anemia megaloblástica por deficiencia de vitamina B12 y la gastritis crónica atrófica corporal difusa (gastritis tipo A), asociándose frecuentemente con otros trastornos autoinmunes. Es una entidad poco frecuente y subdiagnosticada. Se presentan 10 casos de pacientes con anemia megaloblástica (siete mujeres, tres hombres), que consultaron al Hospital Universitario de la Samaritana y al Hospital San Blas, con diagnóstico definitivo de anemia perniciosa

Deteccion de anticuerpos contra la mucosa gastrica en pacientes con gastritis superficial, gastritis cronica atrofica y ulcera duodenal infectados con Helicobacter pylori / Detection antigastric autoantibodies in patients with gastroduodenal disease and infected with helicobacter pylori

Se detectó la presencia de autoanticuerpos contra la mucosa gástrica en pacientes con enfermedad gastroduodenal e infectados con Helicobacter pylori. Métodos: se estudiaron 39 pacientes, se tomaron biopsias gástricas y suero. Los anticuerpos IgG anti H. pylori se detectaron por la técnica de ELISA. Para la detección de anticuerpos antigástricos se utilizaron técnicas de inmunohistoquímica. Resultados: se detectó la bacteria en el 97,5 por ciento de los casos. Los anticuerpos contra la mucosa gástrica se encontraron en el 12,8 por ciento de los pacientes. Se hallaron dos patrones: a) autoanticuerpos contras las células parietales, b) autoanticuerpos contra la membrana apical del epitelio glandular. Conclusión: se evidenció la presencia de autoanticuerpos contra la mucosa gástrica en pacientes con enfermedad gastroduodenal, infectados con Helicobacter pylori. La presencia de autoanticuerpos puede estar involucrada en el desarrollo de la in.amación y posterior atro.a de la mucosa

Deteccion de Helicobacter Pylori en Colombia: diferentes metodologias aplicadas a su estudio en una poblacion de alto riesgo de cancer gastrico / Detection of Helicobacter Pylori in Colombia

En Colombia, país con una alta prevalencia y mortalidad por cáncer gástrico, está comenzando el estudio del Helicobacter pylori (H. pylori), implicado como uno de sus agentes etiológicos. Objetivo: establecer un protocolo para cultivar H. pylori y utilizar este parámetro junto con la prueba de ureasa rápida (PUR), la histología y la serología, para detectar infección en pacientes con adenocarcinoma gástrico y úlcera péptica. Métodos: se estudiaron 76 pacientes con adenocarcinoma gástrico (27 del tipo difuso, 49 del tipo intestinal), 54 con úlcera péptica y 14 con gastritis crónica. Se tomaron biopsias gástricas y suero de cada paciente. El crecimiento bacteriano se evaluó en dos medios sólidos y dos medios líquidos. La bacteria se detectó mediante PUR, histología y cultivo. Los anticuerpos anti-H.pylori se detectaron por inmunotransferencia. Para cada prueba, se determinó sensibilidad, especificidad y valores predictivos. Resultados: el crecimiento del H. pylori fue mejoren medio HPM. Se detectó la bacteria en 29,4 por ciento de pacientes con cáncer gástrico, en 90 por ciento con úlcera péptica y en 93 por ciento con gastritis crónica. Se encontraron anticuerpos en el 100 por ciento de los casos. El cultivo fue la prueba más específica y la histología la más sensible. No se observaron diferencias significativas en la prevalencia de la infección entre los dos tipos histológicos de cáncer gástrico. Conclusiones: aunque el cultivo del H. pylori es exigente, este método es fundamental para estudiar sus factores de virulencia involucrados en las patologías gastroduodenales. En Colombia, la infección por H. pylori tiene alta prevalencia y parece ser un evento común en los dos tipos histológicos de adenocarcinoma gástrico.

Relación existente entre anticuerpos antifosfolípidos y preeclampsia

OBJETIVO: Determinar si existe una mayor prevalencia de anticuerpos antifosfolípidos(anticuerpos anticardiolipinas) en pacientes preeclámpticas y aclarar si existe diferencia en la severidad y pronóstico materno-fetal en relación a los niveles encontrados. DISEÑO DEL ESTUDIO: Se realizó un estudio de casos y controles, tomando como grupo de casos 46 pacientes con diagnóstico de preeclampsia y un grupo control de 25 pacientes sanas. A todas las pacientes se les realizó determinación de ANAS y ACA IgG y se compararon variables relacionadas con complicaciones maternas como síndrome de HELLP, eclampsia, abruptio de placenta, falla renal aguda, y variables neonatales como bajo peso al nacer, presencia de retardo de crecimiento intrauterino(RCIU) y apgar bajo. Se utilizaron pruebas de Chi-cuadrado para el análisis de los datos, considerando uan p<0.05 estadísticamente significativa(truncado 2500 caracteres)